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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 410508446
Report Date: 11/26/2024
Date Signed: 11/26/2024 01:10:39 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/18/2024 and conducted by Evaluator Jaime Vado
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20241118163445
FACILITY NAME:VANESSA CARE HOME IIFACILITY NUMBER:
410508446
ADMINISTRATOR:GALATI, IDAFACILITY TYPE:
740
ADDRESS:1640 ELEANOR DRIVETELEPHONE:
(650) 315-2114
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:6CENSUS: 6DATE:
11/26/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Adminstrator - Tina GalatiTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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- Licensee does not ensure that facility is maintained at a comfortable temperature for residents in care
INVESTIGATION FINDINGS:
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On 11/26/2024 Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit regarding the allegation received. LPA met with caregiver Mimi Arcenio initially then the administrator Tina Gilati arrived around 1250pm. LPA explained the purpose of today's visit.

During the investigation LPA conducted interviews and made facility observations. LPA also made facility observations and took temperature readings in resident rooms and in common areas which ranged from 65F down to 63F towards rooms 4 and 5. Temperature is observed to be 65F based on thermostat reading in the facility. Additonally LPA observed that the thermostat is set at maintaining 65F per observation of the thermostat/centralized heating control in the kitchen area. LPA observed three residents in the dining area. All three are wearing warm clothing such as outdoor vest, with a long sleeve flannel and another with a long sleeve sweater beneath a vest. Another resident is wearing a sherpa jacket with a scarf or head wrap to keep her head and ears warm. The temperature readings and thermostat setting do not meet the minimum 68F as outlined in regulations. Based on the information gathered, and observations made, this allegation is substantiated.

Based on LPA interviews and items letters received, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D. Report is reviewed with the administrator Tina Gilati and a copy is provided.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime VadoTELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 14-AS-20241118163445
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: VANESSA CARE HOME II
FACILITY NUMBER: 410508446
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/02/2024
Section Cited
CCR
87303(b)(1)
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Maintenance and Operation - (b) A comfortable temperature for residents shall be maintained at all times. (1) The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C). This regulation has not been met as evidenced by:
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The facility shall provide a written plan identifying how they will ensure that the facility maintains a minimum temperature of 68F at all times and mearues being taken. This plan is to be received by the due date of 12/02/2024.
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Based on observations made, interviews conducted, and temperature readings taken and observed, the temperature is mainly 65F in some areas. The temperature does go down further to around 63F near rooms 4 and 5. These readings and observations made do not meet the minimum temperature of 68F as outlined in regulations. This poses a potential health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime VadoTELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2